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Silent single coronary artery anomaly depicted by magnetic resonance angiography
Stephan Wicky1, X Lyon, L Kappenberger
1Department of Radiology, University Hospital, CHUV-BH 07, 1011 Lausanne, Switzerland. Stephan.Wicky@chuv.hospvd.ch
Insights
A rare single coronary artery anomaly, where the left main artery arises from the right, can cause chest pain or sudden death. Magnetic resonance angiography precisely maps this anomaly for surgical planning.
Area of Science:
- Cardiology
- Radiology
- Medical Imaging
Background:
- Coronary artery anomalies are uncommon but can lead to serious cardiac events.
- Diagnosis typically involves invasive coronary angiography.
- Single coronary artery anomaly is a rare variant with potential for myocardial ischemia.
Observation:
- A case of single coronary artery anomaly was incidentally discovered during coronary angiography.
- The anomaly involved the left main artery originating from the proximal right coronary artery.
- The anomalous artery coursed between the aorta and pulmonary artery.
Findings:
- Magnetic resonance angiography (MRA) provided a detailed anatomical description of the anomaly.
- MRA accurately depicted the course of the anomalous coronary artery relative to the great arteries.
- The findings facilitated precise surgical planning.
Implications:
- This case highlights the utility of advanced imaging like MRA in characterizing complex coronary artery anomalies.
- Accurate anatomical assessment is crucial for managing patients with single coronary artery anomaly.
- Non-invasive imaging aids in surgical strategy development for these rare conditions.
Abstract:
Coronary artery anomalies are rare and usually benign. They are detected by coronary angiograms during invasive catheterization. Single coronary artery anomaly, with the left main artery originating from the proximal right coronary artery, can be responsible for myocardial blood supply insufficiency and causes chest pain or sudden death, especially during physical exercise, as it courses between the aorta and the pulmonary artery. We report a case of a fortuitous diagnosis of single coronary artery anomaly discovered during coronary angiogram and investigated in addition with magnetic resonance angiography. Magnetic resonance imaging can provide a precise description of the coronary artery anomaly and its course between great arteries, allowing accurate surgical planning.